title: Prevalence of optic disc hemorrhages in rural central India. The Central Indian Eye and Medical Study.
abstract: OBJECTIVE
  To determine the frequency of optic disc hemorrhages in a rural Indian population.
  
  
  METHODS
  The population-based Central Indian Eye and Medical Study included 4711 subjects. Mean age was 48.5±12.9 years (range: 30-100 years). Color optic disc photographs were examined.
  
  
  RESULTS
  Optic disc photographs were available for 4570 (97.0%) subjects. Prevalence of disc hemorrhages was 17/8869 (0.19%; 95%CI:0.10,0.28) per eye and 16/4570 (0.35±0.09%; 95%CI:0.18,0.52) per subject. Prevalence of disc hemorrhages increased from 0.05% (95%CI:0.00,0.13) in the age group of 30-39 years to 0.25% (95CI:0.00,0.49) in the age group of 60-69 years and to 0.91% (95%CI:0.24,1.58) in the age group of 70+ years. After adjusting for older age, higher systolic blood pressure, diabetes mellitus, myopic refractive error, smaller neuroretinal rim area and thinner retinal nerve fiber layer, occurrence of disc hemorrhages was associated only with glaucomatous optic nerve damage (P<0.001; Odds ratio: 87; 95%CI:32,239). Eleven of the 17 (65%; 95%CI:39,90) disc hemorrhages were found in glaucomatous eyes. Out of 193 glaucomatous eyes, 11 eyes (5.7%; 95%CI:2.4,9.0) showed a disc hemorrhage. Out of the 8676 non-glaucomatous eyes, 6 eyes (0.07%; 95%CI:0.01,0.12) had an optic disc hemorrhage.
  
  
  CONCLUSIONS
  Prevalence of disc hemorrhages (0.2% per eye; 0.4% per subject) in Indians aged 30+ years was strongly associated with glaucoma after adjustment for age, blood pressure and diabetes mellitus. A disc hemorrhage suggested glaucomatous optic nerve damage with a positive predictive value of 65%. About 6% of glaucomatous eyes showed a disc hemorrhage at the time of clinical examination highlighting the importance of optic disc hemorrhages for the diagnosis of glaucoma.
authors.affiliation: Suraj Eye Institute, Nagpur, India ; Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University, Heidelberg, Mannheim, Germany.
authors.forename: Jost B
authors.initials: JB
authors.lastname: Jonas
authors.forename: Vinay
authors.initials: V
authors.lastname: Nangia
authors.forename: Anshu
authors.initials: A
authors.lastname: Khare
authors.forename: Maithili
authors.initials: M
authors.lastname: Kulkarni
authors.forename: Arshia
authors.initials: A
authors.lastname: Matin
authors.forename: Ajit
authors.initials: A
authors.lastname: Sinha
authors.forename: Krishna
authors.initials: K
authors.lastname: Bhojwani
authors.forename: Prabhat
authors.initials: P
authors.lastname: Nangia
authors.forename: Songhomitra
authors.initials: S
authors.lastname: Panda-Jonas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007194:India / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D009901:Optic Nerve Diseases / Q000453:epidemiology* / Q000473:pathology*; D015995:Prevalence; D012423:Rural Health / Q000706:statistics & numerical data